To Cut or Not to Cut; That is the Question

Circumcision in the Twenty-first Century

In the past and frankly still today, the decision to circumcise or as the kids say today; “To cut or not to cut,” seems to be primarily religious, familial, cultural or a combination of all three.

Those of us who are not locked into the decision by those forces, have to weigh the options and make a decision on our son’s behalf.

I didn’t realize what a hotly debated issue circumcision was until I started reading about it.

It seems that everyone has an opinion.

To be honest, I don’t believe that I had ever really given it a thought until my son was born.

To Cut or Not to Cut

In my opinion, not deciding or putting off the decision can be summed up by Getty Lee of Rush, who so profoundly stated in the song Freewill, “If you choose not to decide, you still have made a choice!” That choice would be not to circumcise, by default.

This is a yes or no decision.

In the USA, we tend to perform the circumcision within a few weeks following birth.

In other cultures, it is not uncommon for the circumcision to be performed as a ‘rite of passage’ for a pre-teen, teenager or young adult.

How Common is Circumcision?

When making a decision like this, I think it is important to know just how common is this surgical procedure. So let’s take a look at the numbers.

It is the most common surgical procedure performed in the USA.

According to Wikipedia, the World Health Organization (WHO) estimates that one-third of all men are circumcised. The practice is most common among Muslims and Jewish males. Funny, I always thought it was a Catholic thing.

In the USA the numbers vary due to race and ethnicity, however, the overall percentage is estimated as high as 79% for all American born males.

Studies have estimated the prevalence (the percentage of all males, so it is skewed toward the past) of circumcised white males to be as high as 90%. While black, Asian and Hispanic males are at 73%, 50% and 42%, respectively.

What’s Trending?

That being said, the worldwide trend is slowly moving toward non-circumcision.

According to the CDC (Center for Disease Control), from 1979 to 2010 the circumcision rate in the USA has declined by over 10% to as low as 58% of newborn males.

Here is the worldwide breakdown (prevalence):

Africa > 60%

Asia < 20%

Europe < 20%

Latin America < 20%

Includes all of South America, Central America and Mexico

Oceana < 20%

However, the numbers in Australia and New Zealand vary tremendously

USA > 75%

In Europe, changing attitudes toward circumcision have caused the numbers to trend much lower.

In the UK, as few as 5% of males are circumcised, most of which can be attributed to those making the decision on religious grounds.

In 2012 a German court ruled that circumcision was “bodily harm” and essentially child abuse. Since then, it has become quite an issue in the German courts, which are leaning toward the child having the right to make the decision for himself.

However, the German parliament recently passed a law allowing circumcisions to be performed by qualified members of a religious community in the first six months following birth. I can assure you, this trend will gain momentum in other secular nations.

What Does the Medical Community Say?

Now you know a little history, some current numbers and the current trend, it is time to consider what the medical community thinks about the issue.

In 2012, the American Academy of Pediatrics Task Force on Circumcision issued a policy statement, which determined that the benefits of circumcision outweigh the risks of the surgery.

According to the AAP and the Mayo Clinic, the specific benefits of a medically performed circumcision include:

Prevention of phimosis (inability to retract the foreskin), which can lead to inflammation of the foreskin and head of the penis

Decreased risk of the acquisition of HIV

Reduction in the transfer of male-to-female and male-to-male HIV and HPV

Decreased risk of cervical cancer in the female partners of circumcised men

The Other Side of the Coin

According to WebMD here is a list of the problems and risks of circumcision:

Pain

Risk if bleeding and infection

Irritation of the glans (head of the penis)

Increased risk of meatitis (inflammation of the penis opening)

Risk of injury to the penis

Other Things to Consider

Do you believe that the decision is best left to him, anyway?

This school of thought is the current trend worldwide.

Will your child choose to be circumcised at a later date?

Some do, most don’t.

Approximately 3% of uncircumcised children will require circumcision for medical reasons later in life.

As you can see, medical circumcision (after birth) is relatively rare.

Should the child and his father match when it comes to circumcision?

I believe that if they don’t match and the child inquires, that honest and clear communication will quell any feeling of not belonging either way.

Should the siblings match?

Again, if it comes up, communication is the key.

Will a circumcised or uncircumcised child be ridiculed in the locker room for being different?

The times, they are changing. As a society, we are generally more accepting.

What do sexual partners prefer?

I read a couple of articles, which implied that most people do have a preference in their partner, but as long as good hygiene was practiced, the attraction, to the person as a whole, was most important.

Most American doctors agree that the decision should be the parents

It is your job to gather as much information as possible and to make a choice.

It’s Up to You

Now that you have a lot of information on the subject, it is time to decide.

Since I have worked in the sales industry for many years, whenever I am faced with a big decision, I always think of Tom Hopkins and the Ben Franklyn Close. Tom teaches this (sales) closing technique to be used with clients who are struggling to make a decision.

Essentially Tom says to the client, “You know about Ben Franklyn, right? When Ol’ Ben was faced with a tough decision, he would take out a piece of paper, draw a line down the middle and write down all of the reasons to move forward on one side of the line and on the other side, write down the reasons not to move forward. Once this is done, the decision should be obvious.”

It is up to You

There is a little more to it than that, but now that you know the numbers, trends, medical, cultural and religious aspects, which effect the decision, you can follow the advice of Ben Franklin.

I invite you to take out a piece of paper, draw a line down the middle and figure out what you believe is best for your baby boy.

Here are some links to more information which make the arguments for both: in favor and against circumcision.

Update: After doing a little more research and based on my humble opinion, I believe that you can trace the decline in circumcision in the US to the decision by insurance companies to no longer cover the procedure.

Lynn and I requested the information, so that we could make a completely informed decision. Essentially, it costs a couple of hundred dollars.

So, I believe that the financial obligation and the current trend in the country, will lead more and more families in America to decide against circumcision.